42 3rd St RES22-0160 remodel J,
Building Permit Application Updated l0/9/18
City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
_,�3i IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.u5
Job Address: qZ 3 r4 5TREt 1 \ES 22 - CD I C 0
Permit Number: 1
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Legal Descrption 6--0 6'25-2y' .ZyL pi� EofBgk Lo2r7c�
RE# )701613- 0000
Valuation of Work(Replacement Cost)$ /Si dD Heated/Cooled SF 2/6, Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration ®Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial lIesidential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes tio ,
• Will trees)be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) LKNo
Describe in detail the type of work to be performed: I Th QEt e',sr,,v(, BEA%h (--02.7.16E /ti 5,4"1/S,''n_4< f[,..v.c
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P OlhAw 141040 5,.v, LoflMoti A2E4 12Er►1A14,s -, NEcv f/r_E/Aaiti,
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name KEN /32uwniLit 3E4 5i�`i1"
Address
City /}rL,'A,r,,, I3f;4( U State f!. Zip )2233 Phone 0031 s;/s'-Zg2s
E-Mail k y US 2oc e yc hoo. C o M
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) G,,•.NE•C
Contractor Information
AA
Name of Company �v,•/5Hr,vE colisf CO"ST2vCTI" Agent
i/ ,l�Qualifyin Jolt u�7AtiC//
Address r/3 /IC ING$ 1.44/E City AB State FC Zip 31233
Office Phone Yo y. Za y /b i y Job Site Contact Number E-54"nf
State Certification/Registration# C-/J(- /1 5'6 ?vs' E-Mail JO°- L 50iIS ne.Co357-0c . C oi►t
Architect Name&Phone#
Engineer's Name&Phone# //
Workers Compensation Insurer i s I & A 56 CvT'•N5 /ilic. OR Exempt❑ Expiration Date /0/ //4 22
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE: In addition to the requirements of this
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county, and
there may be additional permits required from other governmental entities such as water management districts,state agencies,or
federal agencies.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR , IA P ORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
' f_'' IU7cn__,
(Signature of Owner or Agent) (Si:nature of Contractor) 7
Signed and sworn to(or affirmed)before me this.( £r day of • d and sworn to(or affir •►i before `- this23day of
4.,1 , by Ke- e-4-1, raw.t 2C) ~ by , ES vM • ti.1 -
'nat r- if o •.4 — Notary)
�P�.,• 7•!''' 67,•. TONI GINDLESPERGER
-;�<;�...�,c-JANMAURICIOWALKERROBERTSON :•_^`•• ;
,� MY COMMISSION#HH 009325 •• ' :'•� MY COMMISSION#GG 353178
I ]Personally Known OR . ^;,`o; EXPIRES:June 11,2024 '[:;
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East Side
Job: KEN BROWN
42 3rd STREET
ATLANTIC BEACH, FL 32233
SCALE: 1:40
EAST SIDE VIEW
SUNSHINE COAST CONSTRUCTION
CBC1256395
Phone (904) 208-1084
e-mail joe@sunshinecoastinc,com
20'-18'
1'-10"
5'-118"
12'-2'
16'-38'
East Side
Job: KEN BROWN
42 3rd STREET
ATLANTIC BEACH, FL 32233
SCALE: 1:40
EAST SIDE VIEW
SUNSHINE C❑AST C❑NSTRUCTI❑N
CBC1256395
Phone: (904) 208-1084
e-mail joe@sunshinecoastinc,corn
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Job: KEN BROWN
42 3rd STREET
ATLANTIC BEACH, FL 32233
SCALE: 1:40
NORTH SIDE VIEW
SUNSHINE COAST C❑NSTRUCTI❑N
CBC1256395
Phone! (904) 208-1084
e-mail joe@sunshinecoastinc,con
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Job: KEN BROWN
42 3rd STREET
ATLANTIC BEACH, FL 32233
SCALE: 1:40
NORTH SIDE VIEW